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Congressional Actions Could Help Reduce Proportion in Care' which was
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Testimony:
Before the Subcommittee on Income Security and Family Support,
Committee on Ways and Means, House of Representatives:
United States Government Accountability Office:
GAO:
For Release on Delivery Expected at 10:00 a.m. EDT:
Thursday, July 31, 2008:
African American Children In Foster Care:
HHS and Congressional Actions Could Help Reduce Proportion in Care:
Statement of Kay Brown, Director:
Education, Workforce, and Income Security:
GAO-08-1064T:
GAO Highlights:
Highlights of GAO-08-1064T, a testimony before the Subcommittee on
Income Security and Family Support, Committee on Ways and Means, House
of Representatives.
Why GAO Did This Study:
A significantly greater proportion of African American children are in
foster care than children of other races and ethnicities relative to
their share of the general population. Given this situation, GAO was
asked to analyze the (1) major factors influencing their proportion in
foster care, (2) strategies states and localities have implemented that
appear promising, and (3) ways in which federal policies may have
influenced the proportion of African American children in foster care.
This testimony is based on a GAO report issued in July 2007 (GAO-07-
816), which included a nationwide survey; a review of research and
policies; state site visits; analyses of child welfare data; and
interviews with researchers, HHS officials, and other experts. It
includes updates where possible.
What GAO Found:
According to our survey results, key factors contributing to the
proportion of African American children in foster care included a
higher rate of poverty, challenges in accessing support services,
racial bias and distrust, and difficulties in finding appropriate
adoptive homes. Families living in poverty have greater difficulty
accessing housing, mental health, and other support services needed to
keep families stable and children safely at home. Bias or cultural
misunderstandings and distrust between child welfare decision makers
and the families they serve also contribute to children’s removal from
their homes into foster care. African American children also stay in
foster care longer because of difficulties in recruiting adoptive
parents, the lack of services for parents trying to reunify with their
children, and a greater reliance on relatives to provide foster care
who may be unwilling to terminate the parental rights of the child’s
parent—as required in adoption—or who need the financial subsidy they
receive while the child is in foster care.
Most states we surveyed reported using various strategies intended to
address these issues, such as building community supports, providing
cultural competency training for caseworkers, and broadening the search
for relatives to care for children. Researchers and officials also
stressed the importance of analyzing data to address the proportion of
African American children in care in order to better understand the
issue and devise strategies to address it. HHS provides information and
technical assistance, but states reported that they had limited
capacity to analyze their own data and formulate strategies to address
disproportionality.
According to our survey, states viewed some federal policies, such as
those that promote adoption, as helpful for reducing the proportion of
African American children in foster care. However, they also expressed
concerns regarding policies that limit the use of federal funds to
provide preventive services and support legal guardianship
arrangements. As an alternative to adoption, subsidized guardianship is
considered particularly promising for helping African American children
exit from foster care.
Figure: Proportion of Children in Foster Care Settings, End of Fiscal
Year 2006:
This figure is a combination bar graph showing proportion of children
in foster care settings at the end of fiscal year 2006. The X axis
represents race, and the Y axis represents the percent of population.
Race: White;
Child population: 59;
Foster care population: 40.
Race: African American;
Child population: 15;
Foster care population: 32.
Race: Hispanic;
Child population: 21;
Foster care population: 19.
Race: Asian;
Child population: 4;
Foster care population: 1.
Race: Native American;
Child population: 1;
Foster care population: 2.
[See PDF for image]
Source: GAO analysis of preliminary 2006 data from the Adoption and
Foster Care Analysis and Reporting System and 2006 Census data.
[End of figure]
What GAO Recommends:
In our July 2007 report, GAO recommended that HHS further assist states
in addressing disproportionality. HHS noted that GAO’s recommendation
was consistent with its efforts to provide technical assistance to
states, but it has not addressed the specific actions. GAO continues to
believe that further assistance is important for helping states address
disproportionality. GAO also suggested that Congress consider amending
current law to allow subsidies for legal guardianships. HHS believes
its proposal for restructuring child welfare funding, first offered in
2004, would give states the option to do this, but the viability of
this proposal is uncertain.
[End of section]
Mr. Chairman and Members of the Subcommittee:
I am pleased to be here today to discuss our work on African American
children and the extent to which they are disproportionately
represented in foster care relative to their share of the general
population.[Footnote 1] Nationwide, about 510,000 children were in
foster care at the end of fiscal year 2006, a significant proportion of
them African American children. African American children were about
three times as likely to be placed in foster care compared with White
children in 2006, and African American children remained in foster care
about 9 months longer as well.[Footnote 2] This disproportionality
occurs despite the fact that national studies have shown that children
suffer from abuse and neglect at the same rates regardless of their
race or ethnicity.[Footnote 3] Although states vary considerably, data
from nearly all states show some overrepresentation of African American
children in foster care.
As you know, about 60 percent of children who enter foster care do so
in response to reports of child abuse or neglect that are provided to a
state's child welfare system by doctors, teachers, police officers, and
others.[Footnote 4] Child welfare staff make decisions about whether a
child can or cannot remain safely at home with their families, which
are then presented before a judge who corroborates or overturns the
decision. If a child enters foster care, child welfare staff develop
case plans, approved by the courts, outlining the actions that parents
must take before a child can be returned home. If the courts decide
that children cannot be safely returned home, caseworkers establish
other goals for them, such as adoption or legal guardianship. Although
states have the primary responsibility for establishing the structures
and programs of their child welfare services, federal policies
establish a framework within which states make their programmatic and
fiscal decisions. The Department of Health and Human Services (HHS) is
the principal federal agency that provides federal oversight of states'
child welfare systems.
My remarks today will focus on the following issues with regard to the
proportion of African American children in foster care:
(1)The major factors that have been identified as influencing the
proportion of African American children entering and remaining in
foster care;
(2)the strategies that states and localities have implemented that
appear promising in addressing African American children's
overrepresentation in foster care; and:
(3)the ways in which key federal child welfare policies[Footnote 5] may
have influenced African American children's representation in foster
care.
This testimony is based on findings from our July 2007 report[Footnote
6] on this subject, which we developed using multiple methodologies,
including a nationwide Web-based survey of state child welfare
administrators,[Footnote 7] site visits to multiple states and
counties, and interviews with child welfare researchers and HHS
officials.[Footnote 8] For our 2007 report, we also analyzed HHS data
on foster care and adoption, conducted a review of research on racial
disproportionality in foster care, and analyzed federal legislation and
policies. For this testimony, we updated some information based on
foster care and adoption data sources, but HHS did not provide us with
any updates on its activities in time for this testimony. We conducted
our work between June 2006 and July 2007 and updated as possible in
July 2008 in accordance with generally accepted government auditing
standards. Those standards require that we plan and perform the audit
to obtain sufficient, appropriate evidence to provide a reasonable
basis for our findings and conclusions based on our audit objectives.
We believe that the evidence obtained provides a reasonable basis for
our findings and conclusions based on our audit objectives.
Summary:
A higher rate of poverty and challenges in accessing support services,
as well as racial bias coupled with distrust of the child welfare
system, and difficulties in finding appropriate permanent homes were
identified in our survey of child welfare directors as key factors
influencing the proportion of African American children in foster care.
Thirty-three states in our survey cited high rates of poverty among
African Americans as a factor influencing children's entry into foster
care. Also, families living in impoverished neighborhoods often do not
have access to support services that can help them weather problems
when they arise. However, research suggests that poverty does not fully
account for differing rates of entry into foster care. State child
welfare directors we surveyed also responded that bias or cultural
misunderstanding and distrust between child welfare decision makers and
the families they serve also contribute to the removal of children from
their homes. For children who cannot be reunified with their families,
state officials reported difficulties in finding them appropriate
permanent homes, in part, because of the challenges in recruiting
adoptive parents, especially for youth who are older or have special
needs. African American children also stay in foster care longer, in
part, because of a greater reliance on relatives to provide foster
care. Although this type of foster care placement, known as kinship
care, can be less traumatic for children, it is also associated with
longer lengths of stay.
Researchers and officials stressed that no single strategy would fully
address the issue of disproportionality, and most states in our survey
reported implementing some strategies that experts have identified as
promising for African American children. For example, some states are
working to reduce bias by providing cultural competency training for
caseworkers and to increase access to support services by collaborating
with neighborhood-based support organizations. States also reported
that they were working to increase the availability of permanent homes
by diligently searching for fathers and other paternal kin who could
provide care. However, public and private officials in the forefront of
research and implementation said that the ability to analyze data was
fundamental to any attempt to address racial disproportionality. State
child welfare directors generally reported in our survey that they
needed additional support in analyzing data on disproportionality and
disseminating strategies. Our July 2007 report therefore recommended
that the Secretary of HHS provide states with additional technical
assistance and tools to develop strategies to address
disproportionality. In its comments, HHS noted that our recommendation
was consistent with its efforts to provide technical assistance to
states for addressing disproportionality, but the department did not
address the specific actions we recommended. We continue to believe
that it is important for HHS to take these actions to help states
address this complex issue.
Finally, while states viewed some federal policies as helpful for
reducing the proportion of African American children in foster care,
they also expressed concerns regarding policies that limit the use of
federal funds for services to prevent the removal of children in the
first place and to place children with legal guardians. First, states
expressed concerns that federal funding emphasized finding permanent
homes for children after they had been removed, rather than on
preventing the removal of children from their homes in the first place.
With regard to finding homes for children who had already been removed,
states generally viewed federal adoption policies as helpful in
reducing disproportionality, including federal subsidies for adoptive
families and the requirement to recruit minority adoptive parents.
However, states faced challenges in recruiting enough adoptive parents.
States also considered legal guardianship as particularly helpful in
enabling African American children to exit foster care, but noted that
while they can use federal funds to pay subsidies to adoptive parents,
they cannot do so for legal guardians. Our draft report recommended
that HHS pursue specific measures to allow adoption assistance payments
to be used for subsidizing legal guardianship. In its comments, HHS
disagreed with our recommendation, stating that its proposal for
restructuring child welfare funding would give states the option to do
this. However, HHS has presented this option in its budget proposal
each year since 2004, but no legislation has been offered to date to
authorize it. Because the viability of HHS's proposal is uncertain, in
our July 2007 report we suggested that Congress consider amending
current law to allow subsidies for legal guardianships. To date, the
House of Representatives has passed a bill with a provision to allow
states to use federal funds to subsidize legal guardianship for
relatives, and the Senate has introduced a bill with a similar
provision.
Background:
African American children were more likely to be placed in foster care
than White or Hispanic children in 2006, and at each decision point in
the child welfare process the disproportionality of African American
children grows. Nationally, although African American children made up
less than 15 percent of the overall child population in the 2000
Census, they represented 26 percent of the children who entered foster
care during fiscal year 2006 and 32 percent of the children remaining
in foster care at the end of that year (see fig. 1).[Footnote 9]
Figure 1: Proportion of Children by Race in Foster Care Settings, End
of Fiscal 2006:
This figure is a combination bar graph showing proportion of children
in foster care settings at the end of fiscal year 2006. The X axis
represents race, and the Y axis represents the percent of population.
Race: White;
Child population: 59;
Foster care population: 40.
Race: African American;
Child population: 15;
Foster care population: 32.
Race: Hispanic;
Child population: 21;
Foster care population: 19.
Race: Asian;
Child population: 4;
Foster care population: 1.
Race: Native American;
Child population: 1;
Foster care population: 2.
[See PDF for image]
Source: GAO analysis of preliminary 2006 data from the Adoption and
Foster Care Analysis and Reporting System and 2006 Census data.
[End of figure]
There are various options for placing children in temporary and
permanent homes through the child welfare system. Temporary options
include foster care with relatives or nonrelatives--whether licensed or
unlicensed--and group residential settings. According to HHS,
approximately one-fourth of the children in out-of-home care are living
with relatives, and this proportion is higher for Hispanic and African
American families. For permanent placements, children can be reunified
with their parents, or if reunification is not considered possible,
children can be adopted or live with a legal guardian. Although both
adoption and guardianship are considered permanent placement options
under federal law,[Footnote 10] an important difference is that
adoption entails terminating parental rights, while guardianship does
not. Another difference is that some adoptions may be subsidized with
federal funds.
Federal funds account for approximately half of states' total reported
spending for child welfare services, with the rest of funding coming
from states and localities. In fiscal year 2004, total federal spending
on child welfare was estimated to be $11.7 billion based on analysis of
data from more than 40 states.[Footnote 11] Titles IV-E and IV-B of the
Social Security Act are the principal sources of federal funds
dedicated for child welfare activities. Title IV-E supports payments to
foster families, subsidies for families who provide adoptive homes to
children who states identify as having special needs that make
placement difficult,[Footnote 12] and related administrative costs on
behalf of children who meet federal eligibility criteria. Title IV-E
payments for foster care maintenance are open-ended entitlements. Title
IV-B authorizes funds to states for broad child welfare purposes,
including child protection, family preservation, and adoption services;
these funds are appropriated annually.[Footnote 13] Federal block
grants, such as the Temporary Assistance for Needy Families (TANF) and
the Social Services Block Grant (SSBG), provide additional sources of
funds that states can use for child welfare purposes. States have
discretion to provide direct social services for various populations,
including child welfare families, the elderly, and people with
disabilities.
In 1994, the Congress authorized the use of demonstration waivers to
encourage innovative and effective child welfare practices. These
waivers, typically authorized for 5 years, allowed states to use Title
IV-E funds to provide services and supports other than foster care
maintenance payments. For example, four states had completed
demonstrations that involved subsidized guardianships, and, as of May
2007, seven states had active guardianship demonstrations and one state
had not yet implemented its guardianship demonstration. Demonstration
waivers must remain cost-neutral to the federal government, and they
must undergo rigorous program evaluation to determine their
effectiveness.
States Report Poverty and Difficulty in Finding Permanent Homes Are
among Major Factors Influencing African Americans Entry and Length of
Stay:
A complex set of interrelated factors influence the disproportionate
number of African American children who enter foster care, as well as
their longer lengths of stay. Major factors affecting children's entry
into foster care included African American families' higher rates of
poverty, difficulties in accessing support services, and racial bias or
cultural misunderstanding among child welfare decision makers, as well
as families' distrust of the child welfare system. Factors often cited
as affecting African American children's length of stay in foster care
included the lack of appropriate adoptive homes for children, parents'
lack of access to support services needed for reunification with their
children, and a greater use of kinship care among African American
families. (See fig. 2.)
Figure 2: State Views of Factors Affecting Higher Entry of African
American Children to Foster Care:
This figure is a combination bar graph showing state views of factors
affecting higher entry of African American children to foster care. The
X axis represents the number of states, and the Y axis represents the
factors affecting higher entry of African American children to foster
care.
Poverty-related factors:
Factor: High rates of poverty in African American communities;
Very great extent: 11;
Great extent: 17;
Moderate extent: 5.
Factor: Large number of single-parent African American households;
Very great extent: 4;
Great extent: 10;
Moderate extent: 11.
Factor: High rates of substance abuse in African American households;
Very great extent: 2;
Great extent: 10;
Moderate extent: 12.
Factor: Greater degree of interaction of African American children with
mandated reporters;
Very great extent: 2;
Great extent: 4;
Moderate extent: 8.
Factors related to support services:
Factor: Lack of affordable housing options for African American
parents;
Very great extent: 4;
Great extent: 11;
Moderate extent: 10.
Factor: Lack of access to substance abuse treatment for African
American parents;
Very great extent: 2;
Great extent: 10;
Moderate extent: 11.
Factor: Limited access to family support services to prevent placement
into foster care and re-entry;
Very great extent: 3;
Great extent: 10;
Moderate extent: 11.
Factor: Limited or inadequate legal representation of birth parents;
Very great extent: 3;
Great extent: 7;
Moderate extent: 10.
Factors related to bias:
Factor: Distrust of the child welfare system within the African
American community;
Very great extent: 4;
Great extent: 14;
Moderate extent: 10.
Factor: Racial bias or cultural misunderstanding among those reporting
abuse or neglect to the child welfare agency;
Very great extent: 4;
Great extent: 7;
Moderate extent: 12.
Factor: Caseworker bias, cultural misunderstanding, or inadequate
training in making placement decisions;
Very great extent: 1;
Great extent: 10;
Moderate extent: 10.
Factor: Racial bias or cultural misunderstanding in judicial rulings;
Very great extent: 1;
Great extent: 8;
Moderate extent: 8.
[See PDF for image]
Source: GAO analysis of state child welfare survey responses.
[End of figure]
In our survey, 33 of the 48 states from which we received responses
reported that high rates of poverty in African American communities and
issues related to living in poverty may increase the proportion of
African American children entering foster care compared to that of
children of other races and ethnicities. Across the nation, African
American families were nearly four times more likely to live in poverty
than White families, according to U.S. Census data.[Footnote 14] Since
foster care programs primarily serve children from low-income families,
this could account for some of the disproportionate number of African
American children in the foster care system. In addition, child welfare
directors in 25 states reported that the greater number of African
American single-parent households contributed to African American
children's entry into foster care. According to the most recent
National Incidence Study, children of single parents, who are also more
likely than married couples to be poor, had a 77 to 87 percent greater
risk of harm than children from two-parent families.[Footnote 15]
Across the nation, 34 percent of African American family households
with children under 18 years of age were headed by single females
compared to 9 percent for Whites and 19 percent for Hispanics,
according to U.S. Census data.[Footnote 16]
Moreover, families living in impoverished neighborhoods often do not
have access to the kinds of supports and services that can prevent
problems in the home from leading to abuse or neglect, according to
states we surveyed and other research. Such supports and services
include affordable and adequate housing; substance abuse treatment;
access to family services such as parenting skills workshops and
counseling; and adequate legal representation.[Footnote 17] Also, there
is some evidence that African American families, in particular, are not
offered the same amount of support services when they are brought to
the attention of the child welfare system.[Footnote 18]
Coupled with African American parents' greater distrust of the child
welfare system, racial bias or cultural misunderstanding among decision
makers also emerged in our survey as major factors contributing to the
disproportionate number of African American children entering foster
care. According to state child welfare officials and some researchers
we interviewed, African American families' distrust of the child
welfare system stems from their perception that the system is
unresponsive to their needs and racially biased against them. This
perception can shape the families' dynamics in their initial contacts
with mandated reporters, caseworkers, and judges, which can increase
the risk the child will be removed from the home. In our survey, state
child welfare directors also reported that they considered racial bias
or cultural misunderstanding on the part of those reporting abuse or
neglect---such as teachers, medical professionals, or police officers,
as well as among caseworkers---as factors in the disproportionate
representation of African American children entering foster care. In
support of this view, some studies have found that medical
professionals are more likely to report low-income or minority children
to child protective services.[Footnote 19] Although research on racial
bias or race as a predictor for entry into foster care is not always
consistent, a recent review of the current research concluded that race
is an important factor that affects the decision to place children into
foster care.[Footnote 20]
Among factors cited as affecting African American children's longer
lengths of stay in foster care, officials from 29 states cited an
insufficient number of appropriate adoptive homes as a key factor.
African American children constituted nearly half of the children
legally available for adoption in 2004, and they waited significantly
longer than other children for an adoptive placement. Factors that make
finding adoptive families for African American children challenging
include the difficulty many states have in recruiting adoptive families
of the same race and ethnicity as the children waiting for adoption and
the unwillingness of some families to adopt a child of another race. In
addition, states we surveyed reported that African American children
waiting to be adopted were older, and prospective adoptive parents are
more inclined to adopt younger children.[Footnote 21] (See fig. 3.)
Fig. 3: State Views of Factors Affecting Longer Time in Foster Care for
African American Children:
This figure is a combination bar graph showing state views of factors
affecting longer time in foster care for African American children. The
X axis represents the number of states, and the Y axis represents the
state views of factors affecting longer time in foster care for African
American children.
Factors related to finding permanent homes:
Factor: Insufficient number of appropriate adoptive homes;
Very great extent: 6;
Great extent: 12;
Moderate extent: 11.
Factor: Older (and harder to adopt) foster children are more likely to
be African American;
Very great extent: 7;
Great extent: 10;
Moderate extent: 4.
Factor: African American children are more likely to be diagnosed with
special needs, making them more difficult to adopt;
Very great extent: 5;
Great extent: 5;
Moderate extent: 6.
Factors related to achieving reunification:
Factor: Lack of affordable housing options for African American
parents;
Very great extent: 4;
Great extent: 14;
Moderate extent: 7.
Factor: Distrust of the child welfare system within the African
American community;
Very great extent: 6;
Great extent: 3;
Moderate extent: 16.
Factor: Lack of substance abuse treatment for African American parents;
Very great extent: 3;
Great extent: 11;
Moderate extent: 9.
[See PDF for image]
Source: GAO analysis of state child welfare survey responses.
[End of figure]
Additionally, the belief that African American children are more likely
to be diagnosed as having medical and other special needs, which may
contribute to their longer lengths of stay in foster care, was reported
by state officials. In fact, African American children in foster care
in 2004 were only slightly more likely to have been diagnosed as having
medical conditions or other disabilities (28 percent) than White
children in foster care (26 percent), according to HHS data. However,
23 percent of African American children who were adopted out of foster
care had a medical condition or disability, compared to 31 percent of
White children in the same category.
Some of the same factors that states view as contributing to African
American children's entry also contribute to their difficulties in
exiting foster care and being reunified with their families. In our
survey, nearly half of the states considered the lack of affordable
housing, distrust of the child welfare system, and lack of substance
abuse treatment as factors contributing to African American children's
longer lengths of stay. The lack of such supports and other services in
many poor African American neighborhoods contributes to children's
longer stays in foster care because services can influence a parent's
ability to reunify with their child in a timely manner, according to
our survey, interviews, and research.
States also reported that the use of kinship care was a factor
contributing to longer lengths of stay in foster care for African
American children. African American children are more likely than White
and Asian children to enter into the care of relatives, which is
associated with longer lengths of stay. Relatives may be unwilling to
adopt the child because it would require termination of their
relative's parental rights or because they might lose needed financial
support they receive as foster parents. However, despite the longer
lengths of stay, child welfare researchers and officials we interviewed
consider these placements to be positive options for African American
children because they are less stressful to the child and maintain
familial ties.
States Reported Implementing Strategies Considered Promising for
Addressing Disproportionality but Also Reported Needing More Technical
Assistance:
Researchers and child welfare administrators we interviewed stressed
that no single strategy could fully address disproportionality in
foster care, partly because so many interrelated factors contribute to
it. According to our survey, the strategies that states implemented
tended to focus on addressing racial and cultural bias in decision
making, families' problems in accessing support services, and agencies'
challenges in finding permanent homes so that children can exit foster
care more quickly. In addition, data collection and analysis were
considered essential for identifying problems and devising strategies
to address them, but states reported needing additional assistance in
this area.
To help mitigate bias and cultural misunderstanding among decision
makers, states reported implementing a range of strategies, such as
including family members in case planning; providing training to
strengthen caseworkers' competency in working with families from
various cultures; reaching out to ensure that public officials are not
inappropriately referring families for abuse and neglect through
mandated reporting; and implementing the use of certain tools to help
caseworkers make more systematic decisions regarding the level of a
child's risk. (See fig. 4.) According to an evaluation in Texas, for
example, for African American families who participated in case
planning that included family group decision making, 32 percent of the
children returned home--more than twice as many as in families who
received traditional services.
Figure 4: Number of States Using Strategies to Address
Disproportionality, Grouped by Type of Factor:
This figure is a bar graph showing the number of states using
strategies to address disproportionality, grouped by type of factor.
The bars represent the strategies intended to: improve decisions by
reducing bias, improve access to support services, and to reduce the
length of stay in foster care. The X axis represents the number of
states using strategy, and the Y axis represents strategies to address
disproportionality.
Strategies intended to improve decisions by reducing bias;
Strategies to address disproportionality: Involving family in case
planning process;
Number of states using strategy: 48.
Strategies intended to improve decisions by reducing bias;
Strategies to address disproportionality: Cultural competency training;
Number of states using strategy: 45.
Strategies intended to improve decisions by reducing bias;
Strategies to address disproportionality: Outreach to mandated
reporters;
Number of states using strategy: 37.
Strategies intended to improve decisions by reducing bias;
Strategies to address disproportionality: Recruiting, retaining, and
promoting culturally competent staff;
Number of states using strategy: 36.
Strategies intended to improve decisions by reducing bias;
Strategies to address disproportionality: Use of culturally competent
or validated risk assessment tools;
Number of states using strategy: 29.
Strategies intended to improve access to support services;
Strategies to address disproportionality: Collaboration with
neighborhood-based services;
Number of states using strategy: 38.
Strategies intended to improve access to support services;
Strategies to address disproportionality: Interagency agreements to
improve access to services;
Number of states using strategy: 34.
Strategies intended to improve access to support services;
Strategies to address disproportionality: Alternative, dual or
differential response;
Number of states using strategy: 25.
Strategies intended to improve to reduce the length of stay in foster
care;
Strategies to address disproportionality: Diligent search for fathers
or paternal kin;
Number of states using strategy: 46.
Strategies intended to improve to reduce the length of stay in foster
care;
Strategies to address disproportionality: Recruitment of African
American adoptive families;
Number of states using strategy: 38.
Strategies intended to improve to reduce the length of stay in foster
care;
Strategies to address disproportionality: Subsidies for guardianship at
exit;
Number of states using strategy: 30.
Source: GAO analysis of state child welfare survey responses.
[End of figure]
To improve families' access to services, states reported collaborating
with neighborhood-based support organizations, establishing interagency
agreements to improve access to these services, and implementing an
alternative approach to the assessment process that emphasizes helping
families obtain needed supports and services, instead of removing
children from their families. For example, in Los Angeles County, child
welfare officials went door to door in minority neighborhoods to find
service providers beyond those with whom they historically contracted.
This collaboration helped build trust between the community and the
child welfare agency and increased families' use of the services
provided.
For African American children who cannot ultimately be reunified with
their parents, states also reported devising strategies to increase the
number of permanent homes available to them. To increase the options
for African American children, 46 states reported making diligent
searches for fathers and other paternal kin who can care for these
children--not a routine practice until recently. Additionally, a
federal law passed in 1994 and amended in 1996 require states to
diligently recruit potential foster and adoptive families that reflect
the ethnic and racial diversity of children in the state who need
foster and adoptive homes.[Footnote 22] Likely in response to these
laws, states have adopted various strategies to recruit greater numbers
of African American adoptive parents, such as contracting with faith-
based organizations and convening adoption support teams. However,
despite these efforts, the number of African American children adopted
by African American parents has not increased in recent years. In
addition, HHS's 2001 to 2004 review found that only 21 of 52 states
were sufficiently recruiting minority families, and one report found
that the recruitment of minority families was one of the greatest
challenges for nearly all states.[Footnote 23]
Using subsidized guardianship as an alternative to adoption may hold
particular promise for reducing disproportionality, and more than half
of the states surveyed reported using this strategy.[Footnote 24]
African American children are more likely than White children to be
placed with relatives for foster care, which is generally a longer-term
placement, and these relative caregivers are also more likely than
nonrelative foster parents to be low-income. They may be unwilling to
adopt because they may find it difficult financially to forego foster
care payments or because adoption entails terminating the parental
rights of their kin. However, subsidized guardianship programs provide
financial support for foster parents (often relatives) who agree to
become legally responsible for children but are unable or willing to
adopt. When Illinois and California implemented two of the largest of
such programs, they subsequently saw an increase in permanent
placements for all children. After instituting their subsidized
guardianship programs, more than 40 percent of children who were in
long-term relative foster care in both states found permanency. In
Illinois, this decrease also coincided with a reduction in
disproportionate numbers of African American children in foster care.
In addition to these types of strategies, child welfare administrators
and researchers told us that data collection, analysis, and
dissemination are needed to inform attempts to address
disproportionality. These data can include not only disproportionality
rates but also information that identifies the extent to which
disproportionality occurs among different age groups, at different
stages in the child welfare process, and in different locations. For
example, a California researcher used state data to show that African
American infants enter foster care at a much higher rate than infants
of other races or ethnicities and that this disproportionality grows as
children get older because African American children are also less
likely to exit foster care. Such data analyses help states and
localities devise strategies to address the issue and can also be
useful for building consensus among community leaders and policymakers
for action. However, some state and local agencies have limited
capacity to do this. In responding to our survey, 25 states reported
that receiving technical assistance from HHS in calculating
disproportionality rates and tracking it over time would be
useful.[Footnote 25] California state child welfare officials told us
that without the aid of a university researcher, they would not have
the ability to help counties that lack the capacity to collect and
analyze their data. Despite the importance of data analysis, 18 states
reported that they were not regularly analyzing or using data in their
efforts to address disproportionality.
HHS has made technical assistance and information on disproportionality
available to states at conferences and through various HHS Web sites.
In addition, the agency is compiling an inventory of tools and best
practices for addressing disproportionality. Despite these efforts,
states report that they need further information and technical
assistance to strengthen their current efforts in addressing
disproportionality. Accordingly, in our July 2007 report, we
recommended that HHS take certain actions to further assist states in
understanding and addressing the nature and extent of racial
disproportionality in their child welfare systems. In its comments, HHS
noted that our recommendation was consistent with its efforts to
provide technical assistance to states for addressing
disproportionality, but the department did not address the specific
actions we recommended. We continue to believe that it is important for
HHS to take these actions to help states address this complex issue.
States Reported That More Flexibility to Use Federal Funds for
Prevention Services and Subsidized Guardianship Could Help Reduce
Disproportionality:
While states viewed some federal policies as helpful for reducing the
proportion of African American children in foster care, they also
expressed concerns regarding policies that limit the use of federal
funds to provide preventive services and support legal guardianship
arrangements. As an alternative to adoption, states considered
subsidized guardianship as particularly helpful in enabling African
American children to exit foster care but noted that while they can use
federal child welfare funds to pay subsidies to adoptive parents, they
cannot do so for guardians.[Footnote 26]
At least half the states we surveyed noted that the structure of
federal child welfare funding may contribute to disproportionality by
favoring foster care placements over services to prevent the removal of
children from their homes in the first place. Of particular concern to
28 states in our survey were the caps on funding for preventive and
family support services under Title IV-B, and 25 states expressed
concern about their inability to use foster care funds under Title IV-
E for purposes other than making payments to foster care families. A
recent GAO report similarly found that preventive and family support
services were the services most in need of greater federal, state, or
local resources.[Footnote 27] According to California and Minnesota
officials, because the majority of federal child welfare funds are used
for foster care payments instead of preventive services, federal
funding policies did not align with states' efforts to reduce the
number of children entering foster care by serving at-risk children
safely in their homes. However, states do have the freedom to use other
federal funds, particularly TANF block grants, to provide preventive
and supportive services to families, and 23 states reported that the
ability to use these funds contributes to a reduction in the proportion
of African American children in foster care.[Footnote 28] States face
competing priorities for the use of their TANF block grant funds, and
not all states use them for child welfare activities.
Once children are removed, states reported that federal policies
promoting adoption were generally helpful; however, states' views were
mixed on certain requirements specifically intended to eliminate race-
related barriers to adoption. Policies that promote adoption of African
American children were generally viewed as helpful, such as allowing
states to classify African American children as having "special needs,"
which allows them to provide subsidies to adoptive parents, according
to our survey results. However, views of other requirements were mixed.
Although 22 states reported that the federal policies requiring states
to diligently recruit ethnically and racially diverse adoptive families
would help reduce disproportionality, 9 states reported the federal
requirements had no effect, and 15 states reported that they were
unable to tell.[Footnote 29]
States continue to face challenges in recruiting adoptive families---
such as a shortage of willing and qualified parents, especially for
older African American children, or a lack of resources for recruiting
initiatives---and more than half of states are not meeting HHS
performance goals in this area[Footnote 30]. Over the last 5 years,
African American children and Native American children have
consistently experienced lower rates of adoption than children of other
races and ethnicities, and since 2000, adoption rates have reached a
plateau, according to HHS data and other research.
As an alternative to adoption, many child welfare officials and
researchers we interviewed considered subsidizing legal guardianship a
particularly important way to help African American children exit
foster care. However, there are no federal subsidies for guardianship
similar to those available for adoption, which constrains states'
ability to place children in these arrangements. Seven states have a
federal demonstration waiver, which allows them to use Title IV-E funds
for subsidized guardianship. All states did so in a cost-neutral
manner, as required by the waivers[Footnote 31]. In California and
Illinois, subsidizing these legal guardianships has been found to
reduce the number of children in foster care, including African
American children. In addition, guardianship and adoption both have
been found to provide comparable levels of stability for children and
show similar outcomes in terms of emotional and physical health,
according to an evaluation of Illinois's guardianship program. Because
of the challenges states face finding adoptive homes for many African
American children and because legal guardianship may offer a more
suitable alternative for families who want to permanently care for
related children without necessarily adopting them, we recommended, in
our 2007 draft report, that HHS pursue specific measures to allow
adoption assistance payments to be used for subsidizing legal
guardianship. In its comments, HHS disagreed with our recommendation,
stating that its proposal for restructuring child welfare funding,
known as the Child Welfare Program Option, would give states the option
to do this. However, HHS has presented this option in its budget
proposal each year since 2004, but no legislation has been offered to
date to authorize it. Moreover, even if enacted, it is unknown how many
states would choose to implement this funding structure. Because the
viability of HHS's proposal is uncertain, in our final July 2007
report, we suggested that Congress consider amending current law to
allow adoption assistance payments to be used for legal guardianship.
To date, the House of Representatives has passed a bill with a
provision to allow states to use federal funds to subsidize legal
guardianship for relatives, and the Senate has introduced a bill with a
similar provision.
Mr. Chairman, this concludes my statement. I would be pleased to
respond to any questions you or other Members of the Subcommittee may
have.
GAO Contacts and Acknowledgments:
For further information about this testimony, please contact me at
(202) 512-7215 or brownke@gao.gov. Individuals making key contributions
to this testimony include Kim Siegal, Theresa Lo, Deborah A. Signer,
Gale Harris, and Charlie Willson.
[End of section]
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Faced by Local Programs That Reconnect Youth to Education and
Employment. GAO-08-313. Washington, D.C.: February 28, 2008.
African American Children in Foster Care: Additional HHS Assistance
Needed to Help States Reduce the Proportion in Care. GAO-07-816.
Washington, D.C.: July 11, 2007.
Child Welfare: Improving Social Service program, Training, and
Technical Assistance Information Would Help Address Long-standing
Service-level and Workforce Challenges. GAO-07-75. Washington, D.C.:
October 6, 2006.
Child and Family Services Reviews: Better Use of Data and Improved
Guidance Could Enhance HHS's Oversight of State Performance. GAO-04-
333. Washington, D.C.: April 20, 2004.
HHS Actions Could Improve Coordination of Services and Monitoring of
States' Independent Living Programs. GAO-05-25. Washington, D.C.:
November 18, 2004.
Child Welfare: Enhanced Federal Oversight of Title IV-B Could Provide
States Additional Information to Improve Services. GAO-03-956.
Washington, D.C.: September 12, 2003.
Child Welfare and Juvenile Justice: Federal Agencies Could Play a
Stronger Role in Helping States Reduce the Number of Children Placed
Solely to Obtain Mental Health Service. GAO-03-397. Washington, D.C.:
April 23, 2003 (reissued on August 11, 2003).
Foster Care: Recent Legislation Helps States Focus on Finding Permanent
Homes for Children, but Long-Standing Barriers Remain. GAO-02-585.
Washington, D.C.: June 28, 2002.
Foster Care: Kinship Care Quality and Permanency Issues. GAO-99-32.
Washington, D.C.: May 6, 1999.
Foster Care Implementation of the Multiethnic Placement Act Poses
Difficult Challenges. GAO-98-204. Washington, D.C.: September 14, 1998.
[End of section]
Footnotes:
[1] Racial disproportionality refers to the extent that children of a
certain race or ethnic group are over-or underrepresented in foster
care relative to their proportion in the population.
[2] The difference in length of time in foster care is based on 2004
Adoption and Foster Care Analysis and Reporting System data because we
were not able to obtain more recent data in time for this testimony.
[3] See the National Incidence Study (NIS), a congressionally mandated,
periodic effort of the National Center on Child Abuse and Neglect to
obtain information about the current incidence of child abuse and
neglect in the United States. NIS-1 was published in 1981, NIS-2 in
1988, and NIS-3 in 1996. The NIS-3 findings are based on a nationally
representative sample of over 5,600 professionals in 842 agencies
serving 42 counties in the United States. Reports from the NIS-4 are
anticipated in December 2008.
[4] Children also enter foster care for other reasons, such as their
parents’ illness, death, or disability or because of the children’s
delinquent behavior and truancy.
[5] We are using the term "policy" in this testimony to include federal
laws, regulations, and informal agency guidance.
[6] GAO, African American Children in Foster Care: Additional HHS
Assistance Needed to Help States Reduce the Proportion in Care, GAO-07-
816 (Washington, D.C.: July 11, 2007).
[7] We surveyed the 50 states and the District of Columbia and received
responses from 47 states and the District of Columbia.
[8] Although we focused on African American children in this testimony
and our report, our report also noted points of similarity or
difference with children of other races and ethnicities as appropriate.
Native Americans are also overrepresented nationally, but some are
affected by different child welfare laws and oversight authority than
African Americans, making comparisons challenging. See GAO-07-816 for
more information.
[9] Although racial disproportionality is most severe and pervasive for
African American children, Native American children also experience
higher rates of representation in foster care than children of other
races or ethnicities. It is also important to understand local
variations for Hispanic and Asian children, since they are
underrepresented in foster care nationally and in most states but are
overrepresented in some counties and states. For disproportionality
rates for African American, White, Hispanic, Asian, and Native American
children by state in fiscal year 2004, see appendix II of GAO-07-816.
[10] The Adoption and Safe Families Act of 1997 (Pub. L. No. 105-89)
recognized legal guardianship under federal law as another option for
placing children in permanent homes. Prior to this, children's options
for exiting foster care included being reunified with their parents,
adopted by a relative or nonrelative, or emancipated from foster care
when they had reached a certain age, usually 18.
[11] These data were reported in the Urban Institute 2005 Child Welfare
Survey in May 2006. This funding analysis is the most recent available
that shows federal funding used specifically for child welfare.
[12] The term "special needs" is used in a distinct way in Title IV-E
programs. In order to be considered a child with special needs for the
purpose of providing adoption assistance payments, states must
determine that the child should not return home and have a factor or
condition that would make the child difficult to place for adoption
without such payments. States are provided discretion under federal law
to determine what these factors or conditions are and may include age,
membership in a sibling or minority group, or having a medical or
developmental disability that would make placement difficult. There are
additional eligibility requirements to obtain adoption assistance
subsidies as well.
[13] For further information on Title IV-B funds, see GAO, Child
Welfare: Enhanced Federal Oversight of Title IV-B Could Provide States
Additional Information to Improve Services, GAO-03-956 (Washington,
D.C.: Sept. 12, 2003).
[14] U.S. Census American Community Survey, 2006.
[15] A. Sedlak and D. Broadhurst, Executive Summary of the Third
National Incidence Study of Child Abuse and Neglect. A report prepared
for the U.S. Department of Health and Human Services, (Washington,
D.C., 1996).
[16] U.S. Census American Community Survey data from 2006.
[17] Some child welfare officials also pointed out that lower income
families may be referred to the child welfare system in order to gain
access to such services.
[18] Ann F. Garland et al., "Racial and Ethnic Variations in Mental
Health Care Utilization Among Children in Foster Care," Children's
Services: Social Policy, Research and Practice, 3(3): 133-146 (2000).
[19] For example: R. L. Hampton and E. Newberger, "Child Abuse
Incidence and Reporting by Hospitals: Significance of Severity, Class
and Race," American Journal of Public Health (75) 1: 56-60 (1985). For
information on other studies, see Robert Hill, Synthesis of Research on
Disproportionality in Child Welfare: An Update (Casey-Center for the
Study of Social Policy Alliance for Racial Equity in the Child Welfare
System, 2006).
[20] Robert B. Hill, Synthesis of Research on Disproportionality in
Child Welfare: An Update (Casey-Center for the Study of Social Policy
Alliance for Racial Equity in the Child Welfare System, 2006).
[21] According to our analysis of Adoption and Foster Care Analysis and
Reporting System (AFCARS) fiscal year 2004 data, African American
children are even more disproportionally represented in foster care at
older ages than other children.
[22] See the Multi-Ethnic Placement Act of 1994 (Pub. L. No. 103-382,
§§ 551-553), as amended in 1996 by the Interethnic Adoption Provisions
included in the Small Business Job Protection Act (Pub. L. No. 104-88,
§ 1808), referred to as MEPA/IEP.
[23] Urban Institute Child Welfare Research Program, Foster Care
Adoption in the United States: A State by State Analysis of Barriers
and Promising Approaches (November 2004).
[24] A 2006 report by Generations United found that a total of 35
states and the District of Columbia were subsidizing legal
guardianships, generally through federal IV-E waivers; federal block
grants, such as TANF; or state and local funds. (See [hyperlink,
http://ipath.gu.org/documents/A0/GU-GeneralFactSheetJune.pdf].) Three
of these states, Maryland, New Jersey, and Rhode Island, did not
respond to our survey on disproportionality. Other states may subsidize
guardianships but not limit these subsidies to families involved in the
state child welfare system.
[25] Although 18 states in our survey believed that having reporting
requirements on disproportionality rates in HHS's Child and Family
Services Review process would be useful, nearly as many responded that
it would not be useful. HHS officials told us that this process was
governed by statute and that they could not add such a requirement.
[26] As of May 2007, seven states that were granted waivers to use
Title IV-E funds to provide services and supports other than foster
care maintenance payments were actively using Title IV-E funds to
provide subsidies for guardianships.
[27] See GAO, Child Welfare: Improving Social Service program,
Training, and Technical Assistance Information Would Help Address Long-
standing Service-level and Workforce Challenges, GAO-07-75 (Washington,
D.C.: Oct. 6, 2006).
[28] As with all block grants, state officials determine the use of
these funds and their program priorities.
[29] MEPA/IEP also prohibits foster care and adoption agencies
receiving federal funds from delaying or denying placement decisions on
the basis of race, color, or national origin. Fifteen states reported
that encouraging race-neutral adoptions would help reduce
disproportionality, 18 states responded that this policy had no effect,
and 12 states reported that they were unable to tell.
[30] This is based on HHS data from between 2001 and 2004. Challenges
in recruiting are consistent with survey responses in an earlier GAO
study as well. See GAO-07-75.
[31] According to HHS officials, these programs can be cost-neutral
because the administrative costs associated with maintaining a child in
foster care are no longer incurred with permanent legal guardianships.
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